Causes of Periodontal Diseases

Periodontal disease is caused by certain types of bacteria (germs) that normally grow in the mouth. These bacteria organize to form a biofilm called plaque that collects at the tooth gum margins as an invisible sticky film. With poor care of the teeth, the biofilm will grow and begin to penetrate below the tooth gum margins causing damage to the underlying bone.

At the same time, the film of bacteria will harden to form calcium deposits called calculus on the teeth. Calculus (see arrow on picture below) attaches tightly to the tooth surfaces above and below the gum margins. These deposits, once formed cannot be brushed away. It takes a professional such as a dentist or hygienist to remove the local irritants that have accumulated.
The bacteria continue to thrive on the rough surfaces of the calculus. If they establish themselves below the gum surfaces they produce toxins that damage the gum and bone tissue. With time the crevices around the teeth deepen as the bone underneath recedes to form a diseased space called a periodontal pocket.As the disease progresses the pockets get deeper until the root end is reached. The gum surface may look normal once the disease has progressed far below the surface.

about5At this stage, the bacteria may begin to grow more rapidly to form a gumboil or abscess causing the tooth to become loose and tender. There might still be hope for the involved tooth if the abscess and inflammation can be controlled. If discomfort or pain persists, the only option is to remove the tooth.

Periodontal disease does not affect all the teeth at the same time or to the same degree. Generally the back teeth have more severe breakdown than those in front. The difficulty in plaque removal and complicated root shapes account for this difference.